The Impact of Transvenous Cardiac Devices on Vascular Access Patency in Hemodialysis Patients

Autor: Chieh Suai Tan, Zubin Irani, Stephan Wicky, Steven Wu, Cui Jie, Jennifer Joe, Suvranu Ganguli, Sanjeeva P. Kalva
Rok vydání: 2013
Předmět:
Zdroj: Seminars in Dialysis. 26:728-732
ISSN: 0894-0959
DOI: 10.1111/sdi.12073
Popis: Creating a vascular access in the presence of a cardiovascular implantable electronic device (CIED) in a patient with or approaching end-stage renal disease can be challenging. In this study, we aimed to evaluate the impact of a CIED on the outcomes of vascular access creation in hemodialysis patients and determine their effects on vascular access patency. This is a single-center retrospective review of hemodialysis patients who underwent vascular access creation after CIED placement. Outcomes of vascular access creation and need for endovascular interventions were compared between patients with vascular access created ipsilateral and contralateral to the site of CIED. Comparing patients with arteriovenous (AV) access created ipsilateral to CIED placement (n=19) versus the contralateral side (n=17), the primary failure rate was 78.9% versus 35.3% (p=0.02). For AV accesses that were matured, the median primary patency durations for AV accesses created ipsilateral to the CIED was 11.2 months compared to 7.8 months for AV accesses created contralateral to the CIED (p=1.00). AV accesses created ipsilateral to a CIED have a higher primary failure rate compared with the contralateral arm and should be avoided as much as possible.
Databáze: OpenAIRE